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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406207846
Report Date: 07/17/2024
Date Signed: 07/17/2024 04:34:13 PM

Document Has Been Signed on 07/17/2024 04:34 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:IBARRA FAMILY CHILD CAREFACILITY NUMBER:
406207846
ADMINISTRATOR/
DIRECTOR:		JUANA IBARRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 929-2298
CITY:NIPOMOSTATE: CAZIP CODE:
93444
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
07/17/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 AM
MET WITH:Juana IbarraTIME VISIT/
INSPECTION COMPLETED:
04:40 PM
NARRATIVE
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On July 17, 2024, at 1:30 PM, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced annual inspection at above Family Child Care Home (FCCH). LPA met with Licensee, Juana Ibarra and Assistant/daughter, Guillermina Ibarra. LPA discussed the purpose of the inspection. FCCH operates from Monday to Friday, 5:30 AM – 5:30 PM. Licensee cares for children ages 0 to 12 years of age.

During the inspection, LPA and Licensee toured the inside and outside of the home. LPA observed 1 child napping in the living room and the rest of 7 children were outside playing. The required licensing forms were posted at the day care area. FCCH was free of hazardous items at the time of the inspection. FCCH utilizes living room, 1 bedroom, 1 bathroom, dining area and the fenced backyard. The backyard is enclosed by 5-foot wood fencing. Most of the day-care activities such as coloring, writing, painting are done outside in the covered patio.

Bathroom for children’s use is free of toxins. Smoke and carbon monoxide detectors were tested and found functional, the regulation fire extinguisher was serviced on 12/6/2023. Age-appropriate toys, book, cots, play pens and equipment were observed inside the home. Licensee stated there are guns and ammunition in the home and are stored separately in 2 vaults.

Continued on LIC 809C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 07/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/17/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: IBARRA FAMILY CHILD CARE
FACILITY NUMBER: 406207846
VISIT DATE: 07/17/2024
NARRATIVE
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 LPA reviewed the facility file and found that the Pediatric CPR and First Aid certificate expires on 3/11/2025 while Mandated Reporter Training expires on 12/19/2024. LPA reminded Licensee of their responsibility to renew the required training. Children’s records were reviewed and found complete.

Licensee checks and logs sleeping infant every 15 minutes. The Individual Safe Sleep Plan was filled out for infants 0-12 months old. FCCH conducts and logs the fire and disaster drills every month, last drill was conducted on 7/8/2024.

During the inspection and interview process, Licensee disclosed that Janzin Ressegger moved in to the home in June 2024 and upon receiving a letter - DOJ Applicant Fingerprint Response from Department of Justice (DOJ), licensee believed it indicated a criminal record clearance thereby allowing Ms. Janzin to move in. LPA reviewed the DOJ letter and it shows Today, deficiency was cited under Title 22 Division 12. (LIC 809D). A civil penalty of $500.00 was assessed.



LPA Reyes informed Ms. Ibarra that this report dated 7/17/2024 documents a Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.
Also, LPA Reyes informed the licensee, Ms Ibarra to provide a copy of this licensing report dated 7/17/2024 that documents any Type A citation to parents/guardians of all children currently enrolled, by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification

Continued on LIC 809 C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: IBARRA FAMILY CHILD CARE
FACILITY NUMBER: 406207846
VISIT DATE: 07/17/2024
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee, was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee, Juana Ibarra and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

LPA also informed licensee, the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Continued LIC 809C.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/17/2024 04:34 PM - It Cannot Be Edited


Created By: Gigi Reyes On 07/17/2024 at 03:34 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: IBARRA FAMILY CHILD CARE
FACILITY NUMBER: 406207846

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Deficiency Dismissed
Type A
Section Cited
HSC
1596.871(c)(1)(A)
Administration of Child Day Care Licensing
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above Janzin Ressegger moved in to the home prior to clearance of the criminal record which poses an immediate health, safety or personal rights risk to persons in care. Ms. Ressegger obtained criminal record in 11/20/2023 which still shows in process.
POC Due Date: 07/18/2024
Plan of Correction
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Licensee agreed to ensure that Ms. Ressegger must have a criminal record clearance prior to going back to the home, and wrtten plan of correction will be submitted to CCL no later than 7/18/2024, stating the measure to prevent the recurrence of the incident.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Maria Mueller
LICENSING EVALUATOR NAME:Gigi Reyes
LICENSING EVALUATOR SIGNATURE:
DATE: 07/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/17/2024


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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: IBARRA FAMILY CHILD CARE
FACILITY NUMBER: 406207846
VISIT DATE: 07/17/2024
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Licensee is not providing Incidental Medical Services (IMS). IMS policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee, Juana Ibarra was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During today's inspections, deficiencies were cited under Title 22 Division 12.



A notice of site visit was given to Licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the licensee, Juana Ibarra
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024
LIC809 (FAS) - (06/04)
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